Gunshot Injuries in Children

Abstract

Ninety consecutive patients from 2-15 yr of age sustaining gunshot wounds were analyzed and a management algorithm evolved. Key management steps included fluid resuscitation in the field by trained paramedical personnel and recognition of the severity of the wound when large-caliber or shotgun injuries were encountered. Arteriograms were most helpful in locating vascular injuries; venograms were inaccurate. Morbidity was directly related to missile size and impact area, and to the number of organs injured. Any hospitalization beyond 2 wk should have social service, home-bound school service, psychiatry and physical therapy in consultation. During a 5-yr period only 2 of the 90 patients died secondary to hemorrhagic shock.